TREATMENT
Diagnosis of heel spurs includes an examination by a specialist, ultrasound and X-ray imaging. Treatment of plantar fascitis is mostly conservative. Its goal is to heal damaged structures, relieve pain, stretch soft structures and strengthen leg muscles.
It includes:
- relief from painful activities
- the use of orthopedic insoles for the feet, insoles that properly support and relieve the feet or heel pads that relieve the heel and reduce pressure on the painful area
- cryomassage (ice massage) 5-6 times a day for about 15 minutes
- anti-inflammatory drugs
- classical physiotherapy as a combination of different procedures (electrotherapy, magnetotherapy, laser and ultrasound)
- manual therapy
- cross friction massage directly on the painful area
- shock wave therapy, the aim of which is to cause irritation in the injured area through sound pulses and thus stimulate the healing process
- Stretching exercises
- immobilization during the night in dorsiflexion of 5 degrees
Each of the above forms of non-operative treatment should be combined with orthotic therapy. One of the first measures in treatment should be placing a silicone insole under the heel. By applying orthotic therapy, the tension of the plantar fascia, which is caused by excessive pronation of the foot, is reduced by supporting the medial longitudinal arch of the foot. In the case of an indented foot, an orthopedic insole supports the arch of the foot and relieves the tension of the plantar fascia.
It is especially important to check the athlete’s jumping and running technique, and to diagnose the training process in order to reduce the load on the foot and thereby shorten the recovery time. In addition, the footwear should be checked in such a way that hard and narrow shoes are avoided and replaced with soft shoes such as sports ones. Another option that is clinically proven to help with patients who suffer from plantar fasciitis is wearing Dr. Luigi medical footwear. Orthopedic specialist conducted practical testing and noticed that the pain is alleviated among patients who suffer with this condition. Most patients confirmed that the main reason for their pain relief when walking was wearing Dr. Luigi footwear. In analyzing the main reasons that caused the pain relief, multiple reasons were named such as: sole and vamp flexibility, and a lightweight and special anatomical design that is formed by the body weight of the user. This last characteristic is considered particularly important because this footwear can be recommended as a medical device to people who experience pain while walking or standing.
Patients sometimes receive various injections (blockades) at the site of pain as therapy. They are mostly combinations of analgesics (painkillers) and corticosteroids (medicines that prevent inflammation). Corticosteroids weaken the connective structures in the plantar fascia and can cause the fascia itself to rupture. After that, they are pain-free for a while, but the symptoms almost always return. In addition, they do not solve the real cause of the inflammation and are not a good form of treatment. Injections should generally be avoided in the first stages of treatment because there are proven treatment methods that give excellent results.
Surgical treatment of plantar fasciitis (fasciotomy) and postoperative rehabilitation is undertaken in patients whose disease symptoms last longer than 6 to 12 months, despite correctly performed conservative treatment. The operation can be performed through a small incision at the back of the heel to free the plantar bundle and in some cases release the nerve that is pressed at the same time. Athletes who endure extreme loads during training and competition most often belong to this group. Previously, most surgical interventions were aimed at removing the bony heel spur, however, the results were not satisfactory, because the bony spur is not the cause but the consequence of plantar fascitis.
S.R.
20.09.2022
